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Information on the treatment of Pectus Excavatum with a vacuum bell primarily circulates among surgeons and paediatricians. Such information is only really made available to patients refusing operative cosmetic treatment. This post attempts to convey the key points associated with vacuum bell therapy in order to better inform those seeking a treatment from Pectus Excavatum.

The vacuum method was used as early as 1910 by Lange for elevating the sternum, but was not applied to a large number of patients, and long-term results were not documented. The modern vacuum bells used in the treatment of Pectus Excavatum are the Costa and Klobe vacuum bells. Additionally, it is important to note that the engineers of both products suffered from Pectus Excavatum themselves before using a vacuum bell to treat the condition.

Initial results of vacuum bell treatment have proved dramatic, and the acceptance and compliance of patients seems to be good. In many cases of Pects Excavatum, the degree of the deformity does not immediately warrant cosmetic surgery, yet patients may greatly benefit from some type of non surgical treatment. Other patients are disinclined to undergo surgery because of possible complications associated surgery and post operative recovery or because of the pain associated with cosmetic surgery, not to mention the risk of imperfect results. Thus, the introduction of the vacuum bell for the conservative treatment of Pectus Excavatum has generated much interest among patients with the disorder, particularly given the positive effects experienced by those undergoing vacuum bell treatment.

However, the success of vacuum bell therapy not only requires a good technique, but also depends on an appropriate patient vindication/determination. This is evident from the results of a recent medical study:

  • Patients with symmetric and mild Pectus Excavatum seemed to show a more successful outcome than those with asymmetric and deep Pectus Excavatum
  • The application of the vacuum bell was well tolerated by both paediatric and adult patients.
  • All patients except one were satisfied with the use of the vacuum bell, although objectively assessed improvement of Pectus Excavatum varied between the individuals.
  • All our patients were recommended to carry on undertaking sports and physiotherapy, so that the accompanying improvement of body control was an important factor in outcome.
  • The participation of patients themselves in the ?active? treatment of Pectus Excavatum clearly increases motivation to maintain therapy.
  • The manufacturers instructions and our treatment protocol recommended application of the device twice daily for 30 min each. However, the definitive duration and length of use was determined by the individual patient and the parents, respectively.
  • As proved using a the CT-scan, the force of the vacuum bell is strong enough to deform the chest within minutes.
  • The application of the vacuum bell has to be performed carefully

For more information about this medical study, please read this post.

When creating the vacuum, the elevation of the sternum is obvious and persists for a distinct period of time. Therefore, the vacuum cup may also be useful in reducing the risk of injury to the heart during the MIRPE procedure, where the riskiest step of the procedure is the advancement of the introducer between the heart and sternum. Since the manufacturers of the vacuum bell devices do not yet a license to sterilize the vacuum bell, this additional use has to be considered as a clinical trial. During this trial, in accordance with a hospital hygienist, the vacuum bell was applied during the MIRPE procedure in a few patients and produced a good experience and promising results. In addition, the vacuum bell may be useful in a way of ?pretreatment? to surgery, however, this hypothesis is yet to be confirmed.

To summarize, the vacuum bell can allow for patients with Pectus Excavatum to avoid surgery. Especially patients with symmetric and mild Pectus Excavatum, who semm to benefit most from this procedure. Additionally, the intraoperative use of the vacuum bell during the MIRPE may facilitate the introduction of the pectus bar, though this requires further evaluation. In any case, the method seems to be a valuable adjunct therapy in the treatment of Pectus Excavatum.


There are some really great exercises which can be extremely effective at treating and improving Pectus Excavatum. Breathing exercises are an excellent place to start, as they target the patients lung capacity and work the diaphragm and muscles surrounding the ribs and chest. By performing breathing exercises you are helping to strengthen the muscles surrounding the ribs which will ultimately help to pull the chest into a more appealing shape. An example breathing exercise, would be breathing squats.

Arguably, the most effective exercise for treating Pectus Excavatum is the dumbell pullover. This exercise really stretches the muscles in the chest which are neglected by most chest exercises and can really help to improve the appearance of the chest. Many of our users have noted significant improvements in the appearance of their chest from this exercise.

Another great exercise for treating Pectus Excavatum is the dumbbell fly or some other variation of a fly. Dumbbell Fly’s really stretch the muscles in the chest and encourage them to respond by pulling the chest into a more appealing shape.

Another good exercise, just to help with the overall appearance and strength of the chest is push ups.

Finally, whilst it doesn’t not directly relate to the chest, it is important not to neglect your core, as your core has a profound effect on your posture and ultimately the shape of your chest. Thus, core exercises such as situps are a great addition to any Pectus Excavatum workout.


Australia / New Zealand


Professor Richard B. Chard (Sydney)
Adult and Paediatric Cardiothoracic Surgeon
Suite 8, Level 1
Children’s Hospital Medical Centre
Hainsworth St, Westmead NSW 2145
Telephone (02) 9687 9200
Fax (02) 9684 8300

John Harvey
phone: 0298453235
Westmead children’s hospital


Dr Morgan Windsor (Brisbane, Qld)
Thoracic Surgeon
Holy Spirit Northside Medical Centre, Rode Rd, Chermside
(07) 3861 4922


Dr Robin Brown (Melbourne)
9342 8952, 9347 9077

Dr Alex Auldist
Paediatric Surgeon

Based At: Royal Childrens Hospital, Melbourne

Contact through the Royal Children’s Hospital Switchboard:
(03) 9345 5522

John Goldblatt – Royal Melbourne Hospital

Gavin Wright – St. Vincents Hospital

Phillip Antippa – Royal Melbourne Hospital

Simon Knight – Austin Hospital

Bruce Davis – Cabrini Hospital Malvern


David Andrews
Cardiothoracic Surgeon
Suite 34
Mount Medical Centre
146 Mounts Bay Road

Perth, WA, 6000
Phone (08) 9486 1453


Dr Ross Blair (New Zealand)


Victoria, British Columbia

Dr. Allen Hayashi MD
Victoria BC Pediatric Surgeon @ Victoria General

tel: 250.592.4313

Vancouver, British Columbia

Erik Skarsgard
Erik D. Skarsgard, MD, FRCSC, FACS
Associate Professor and Head,
Division of Pediatric General Surgery
Children’s and Women’s Health Centre of B.C.
4480 Oak Street, Vancouver, B.C. V6H 3V4
Phone: (604) 875-3744 Fax: (604) 875-2721

Dr. James Bond
214 – 13710 – 94A Avenue
Surrey, BC V3V 1N1
Phone: (604) 588-5634
Fax: (604) 588-5638
MOA: Sandra –

Hamilton, Ontario

Dr. Peter Fitzgerald
McMaster Children’s Hospital
Hamilton, Ontario


Dr C Compeau
General & Thoracic Surgeon

St Joseph’s Medical Centre
The Queensway

(416) 530 6530

Dr Shaf Kevsafjee
Toronto General

Toronto , Ontario

Dr. A Feteau
Toronto Sick Children

Norfolk, VA

Tina Gustin, RN, MSN, CNS
Pectus Program Coordinator
Pediatric Surgery
(757) 668-8751 Phone
(757) 554-5362 Pager
601 Children’s Lane
Norfolk, VA 23507
(757) 668-8860 Fax



Steve C. Chen, MD FACS
Co-Director, Pediatric Surgery

Cedars-Sinai Medical Center

8635 W. Third St., Suite 1150 W
Los Angeles, CA

(310) 423-2331

Robert D. Acton, M.D.
Assistant Professor of Surgery & Pediatrics

Chicago, illinois

Dr. Donald Liu
University of Chicago Childrens Hospital
5721 S. Maryland Ave
Chicago IL. 60637

Los Angeles California

Dr. Eric W. Fonkalsrud
Department of Surgery
UCLA Medical Center
Los Angeles California USA
(310) 825-6712

Steve C. Chen, MD FACS
Co-Director, Pediatric Surgery

Cedars-Sinai Medical Center

8635 W. Third St., Suite 1150 W
Los Angeles, CA

(310) 423-2331

c/o Pediatric Staff 4NE
Cedars Sinai
8700 Beverly Blvd.
Los Angeles, CA, 90048

Los Angeles California

Los Angeles / Long Beach, California

Daniel M. Bethencourt, M.D.
Director, Pediatric Cardiothoracic Surgery

Long Beach Memorial / Miller Children’s Hospital

2865 Atlantic Ave., Ste 205
Long Beach , CA 90806
(562) 988-9333

Little Rock, Arkansas

Arkansas Children’s Hospital, 800 Marhsall street #837

Little Rock, AK 72202

Evan Kokoska M.D

ph 501-364-1446


Dr. William Loe,
JR from Pediatric Surgery of Louisiana
San Diego, CA

Rady Children’s Hospital and Health Center
3020 Children’s Way
San Diego, CA 92123
Contact Person: Barry E. LoSasso, M.D. x6721


Dr. Brian Gilchrist
Tufts New England Medical Center Floating Hospital for Children
800 Washington Street #281
Boston, MA 02111
Phone: (617) – 636 – 6270

Ann Arbor, Michigan

Dr. Arnold G. Coran
Pediatric Surgery Clinic
C.S. Mott Children’s Hospital
University of Michigan Health System
1500 E Medical Center Dr
Ann Arbor, MI 48109

Detroit, Michigan

Dr. Langenburg, Children’s Hospital

Royal Oak, Michigan

Dr. Chan & Dr. Mordon
Pediatric Surgeons
3535 West Thirteen Mile Road
Suite 748
Royal Oak, Michigan 48073

Dr. Riggs, M.D.
Chief, Pediatric Cardiology
3535 West Thirteen Mile Road
Suite 707
Royal Oak, Michigan 48073

William Beaumont Hospital
3601 West Thirteen Mile Road
Royal Oak, MIchigan 48073

Minneapolis, Minnesota

Drs. Daniel Saltzman & Robert Acton
University of Minnesota Fairview Clinic
specializing in the leonard procedure

(612) 626-4214

Minneapolis, Minnesota
Department of Surgery
Medical School
Room 11-136 Moos Tower
Mayo Mail Code 195
420 Deleware Street S.E.
Minneapolis, MN 55455
Office: 612-626 4214
Fax: 612-624-6969

Houston, Texas
Houston Pediatric Surgeons
St. Luke’s Medical Tower
6624 Fannin, Suite 1590
Houston, Texas 77030

Toll Free 888 796- 1600
Fax 713-796-0397

Dr. Robert S. Bloss
Dr. Allen L. Milewicz
Dr. Mark V. Mazziotti
Dr. Eugene S. Kim
Dr. Robert K. Minkes
Cincinnati, Ohio

Victor F Garcia, MD, FACS, FAAP
Professor of Surgery
Division of Pediatric Surgery
(513)636-7657 fax

Cincinnati Children’s Hospital Medical Center
3333 Burnet Avenue
Cincinnati, OH 452229-3039

Nationwide Children’s Hospital

700 Children?s Dr.
Columbus, OH 43205
Phone: (614) 722-3900
Fax: (614) 722-3903

Brian Kenney, MD, MPH – Clinic director

Gail Besner, MD – Pediatric Surgeon

Chapel Hill, North Carolina

Chapel Hill, North Carolina
[originally posted by Audreysmom]

UNC Chapel Hill Children’s Hospital
J. Duncan Phillips, MD
Associate Professor

Lynne Farber, RN,BSN
Clinical Instructor
Colorado, Denver.
David A. Partrick. M.D.

Assistant Prfessor of Sugery & Pediatrics
Director of Surgical Endoscopy

Phone (303) 861-6571
Clinic appoinments: (303) 861-6182

1056 East 19th Avenue, B323
Denver Colorado 80218

Miami, Florida

Cathy A. Burnweit, M.D.
Pediatiric Surgeon
General – Thoracic – Urologic
Miami Children’s Hospital
3200 S.W. 60th Court, #201
Miami, Fl 33155
PH# 305-662-8320

Tampa / St. Petersburg, Florida

Dr. Jeffery Jacobs
Cardiac Surgical Associates, 603 Seventh Street South, Suite 450
St. Petersburg, FL 33701
United States

Phone: 1 727 822 6666
Fax: 1 727 551 0404

Web: , ,

Rochester, Minnesota
The Mayo Clinic
Claude Deschamps, M.D.
Professor of Surgery
Division of General Thoracic Surgery

200 First Street SW
Rochester, Minnesota 55905

Fax: 507-284-0058

New Brunswick, NJ
Manisha Shende, M.D.
Assistant Professor
Thoracic Surgery
Division of Cardiothoracic Surgery
One Robert Wood Johnson Place, P.O. Box 19
New Brunswick, NJ 08903-0019
Phone: (732) 235-7802
Fax: (732) 235-8150
Cleveland, Ohio
Cleveland Clinic , Pediatric Surgery

9500 Euclid Ave. Cleveland , OH 44195

Surgeons – John DiFiore M.D

Anthony Stallion M.D

Oliver Soldes M.D

Jackson, Mississippi

Dr. Michael Koury
General Surgery
1421 N State St
Suite 304
Jackson, MS 39202

New York City

Dr. Charles Stolar
Children’s Hospital of NewYork-Presbyterian
Columbia University Medical Center
3959 Broadway 212 North
New York, New York 10032


Dr. Columbani, John Hopkins

Washington, USA

Seattle Children’s Hospital Nuss Surgeons

Dr. Clinton M. Cavett ? (206) 987-2794
Dr. Robert Sawin ? (206) 987-2794
Dr. Stephen Kim ? (206) 987-2039

Children?s Hospital and Medical Center
4800 Sand Point Way
Department of Surgery
Box 359300, G0035
Seattle, WA 98105-0371

Tbilisi, Georgia

Dr.Paata Gvetadze

Iashvili kids hospital, ravitch technique


Riley Hospital in Indianapolis

Frederick J. Rescorla, MD
Director of Pediatric Surgery
(317) 274-4681
(317) 274-4491 (fax)

Riley Hospital for Children
702 Barnhill Dr.
Indianapolis, IN 46202

Iowa City, Iowa

University of Iowa Hospitals and Clinics ,Dr. John Meehan
ph. 319-356-1884

Los Angeles

Fonkalsrud, Eric W. M.D.
Professor, and Emeritus Chief of Pediatric Surgery
UCLA Medical Center
Los Angeles CA

Portland, Oregon

Dornbecher Childrens Hospital Portland Oregon

Kansas City, Missouri , Nuss Procedure

Dr. Sharp & Dr. Ostlie


Hershey Medical Center, Hershey PA

Phoenix, Arizona

Dr. Dawn Jaroszewski

Mayo Clinic Phoenix Arizona

5777 E Mayo Boulevard

Phoenix, Arizona 85054

Tucson Arizona

Cosentino, Catherine M MD FAAP FACS
2380 N Ferguson Av Ste 106
Tucson, AZ
(520) 795-5338

San Antonio

North Central Baptist Hospital

Dr Charles Baldwin

South Carolina Charleston,

SC Medical University of South Carolina

96 Jonathan Lucas St., Suite 418 CSB, Charleston , SC 29425

Andre Hebra, M.D.

Greenville, SC

Dr. Michael Gauderer
Pediatric Surgery
Memorial Medical Office Building
Suite 440
890 W. Faris Road
Greenville, SC 29605

FAX (864)455-4170

Hershey, Pennsylvania

Dr. Robert Cilley, ped PE, Nuss procedure, 866-204-0305
Pediatric Reconstructive Surgery
Penn State’s Hershey Medical Center
500 University Drive
Hershey, PA 17033

Virginia State

Children’s Hospoital of the King’s Daughters

601 Childrens LN, Norfold, VA , USA

(757) 668-7098


– Donald Nuss M.D

Robert Kelly M.D

Michael Goretsky M.D

Robert Obermeyer M.D

Ann Kuhn M.D

Winston Salem NC

Wake Forest University Baptist Medical Center – Ravitch

Dr. Michael Hines

Buenos Aires, Argentina

Hospital Privado de Ninos, Fundacion Hospitalaria

Cramer 4601- 3er piso – C1429AKK

(5411) 4704 – 6006 4702-3116 4703-2333 , Ciudad Autonoma de Buenos Aires

Marcelo Martinez-Ferro M.D,


England UK

Birmingham Heartlands hospital, England UK

Birmingham Childrens Hospital

England UK

Dr. Simon Jordon

Royal Brompton Hospital, London, UK

Dr. David Ross (more cosmetic option)

Guys Hospital – Southwark



Philatov Moscow Pediatric Clinical Hospital

Dr. Professor Razumovsky

nuss procedure


Danmark ?rhus. skejbyssyghus

Skejby Sygehus
Brendstrupg?rdsvej 100
8200 ?rhus N

Tlf.: 89 49 55 66
Email :



Helios Kliniken

Professor Schaarschmidt


Lund Sweden

Erik Gyllstedt
Lund Universitets sjukhus (Lund Sweden)

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